Urethrotome.



W. W. BREDIN.- URETHROTOME. APPLICATION FILED SEP'I 6, 1910.

1,015,472. Patented Jan.23,,1912.

wum vboz UNITED STATES PATENT OFFICE. I

WILEiON W. BREDIN, OF DENVER, COLORADO.

naETHRoToME.

To all whom it may concern:

Be it known that I, I/VILSO WV. BRE IN, a citizen of the United States,residing in the city and county of Denver and State of Col orado, haveinvented certain new and useful Improvements in Urethrotomes; and I dodeclare the following to be a full, clear, and exact description of theinvention, such as will enable others skilled in the art to which itappertains to make and use the same, ref erence being had to theaccompanying drawings, and to the letters and figures of referencemarked thereon, which form a part of this specification. I

My invention relates to improvements in urethrotomes or instruments forcutting strictures in the urethra. This instrument possesses thefollowing advantagesover any-- thing in the prior art so far as I amaware- The knives operate within a guide from which they cannotpossibly, escape, said guide being made sufliciently small, fora.

distance of an inch and a half at the end, so that any stricture, nomatterhow narrow, can readily be made suiiiciently patent to admit it,the guide at the same time being sutliciently long so that it must passseveral inches through the stricture before it reaches the bulb in whichthe knives areconcealed,

thus making it absolutely certain thatthe knives when protruded mustcome directly in contact with the walls of the stricture and nothingelse. walls of the urethra at the points where'the knives enter thestricture, are pushed out by the bulb and stretched, whereby they are absolutely protected from any possibility of coming in contact with theknives. knives cannot out anything but the strictured portions of theurethra The bulb is sufliciently large to conceal knives with s'uf:ficient cutting caliber to out any stricture of the urethra to asuflieient depth to'make the operation thorough and eifectiveq Theinstrument has four knives, enabling the operator to make four incisionsat one time, of sufficient depth to do eifectivework. The instrument hasa bulb following the knives as they pass through. the stricture,sufliciently large to prove that the stricture has 7 been successfullydivided. It issimple in construction, easily'taken apart and easilysterilized. By its use a stricture can be s'uc Specification ofLettersPatent.

Furthermore, the healthy The Patented Jan. 23,1912,

Application filed September 6, 1910.. Serial No. 580,595.

Every adult male urethra of normal cali'- her will admit the bulb ofthis urethrotome, and if not it can readily be'made'to admit it. Theknives glide readily backwarc'l and forward in the slots with which theinstrument is provided, their edges being protected from contact withthe edges adjacent the slots by a feather or spline on the rod carryingthe knives, which keeps the knives alwaysin the center of the slots. Thetravel of the knives while cutting the stricture is under the control ofa stop nut threaded on the rod, and which may be adjusted to allowtheinward movement of the knives to the desired predetermined degree.

Having set forth what I consider the main in detail, reference beingmade to the accompanying drawing in which is. illustrated an embodimentthereof. H j

In this drawing: Figure 1' is an elevation of the comnlete instrumentwith the parts assembled for use, the knives being partly advantages ofmy improved instrument, and

- inso doing having briefly outlined the con- 'struction, I w1ll proceedto describe the same exposed protruding through the slots formed in theguide memberof theinstrument; Fig. '2 is a longitudinal sectional viewof the instrument'viewed at right angles to the position shown n Fig. 1,and shown on a larger scale It is shown broken ntermediate 1tsextremitiesfor laek of room on the sheet to make the'view of the properlength to correspond with the diameter of the parts. In

this view the instrumentis shown approximately full size except as to.length. Fig. 3

is a detail view of the guid emember having eoj.

the bulb for concealing the knives. at is a detail view of thecylindrical body member of the instrument which is shown full size. Fig.5 is a detail view of the rod equipped with the knives and upon which astop nut is also shown threaded. In this viewflthe rod is shown nearlyfulllength. Fig; 6' is an end viewo f' the bulb 'extrernity' of theguide member, or a view looking in? the direction of arrow 6 Fig. .8,shown, however, on a larger scale, being approximately double thediameter of the corresponding part in Fig; 3. Fig.7 is a perspectiveview illustrating the vforward extremity of the knife-carrying rod',"thegreater portion 01' I the member' being broken away. cessfully dividedin any part of the urethra. I -55 It is a meatotome as well as aurethrotome'. v

Let the numeral 5 designate a cylindrical tube constituting the bodymember of the instrument, the same being equipped with two rings 6 madefast thereon by brazing or otherwise and located on opposite sides ofthe tube for convenience of operation. The end of the tube 5 remote fromthe rings 6 is reduced in diameter and threaded as shown at 7 forming ashoulder 8 at the inner end of the threaded portion. This tube isprovided at its rear extremity with a screw plug 9 having an exposedmilled head 10, the plug being perforated to receive the rod member 12which passes therethrough when the parts are assembled. This rod memberis relatively long, since it passes entirely through the tube 5 andprotrudes from both ends thereof. The rear end is provided with a ring18.- The portion of the rod extending rearwardly for some distance fromthis ring is threaded as shown at 14 to receive a stop nut 15, whichwhen the device is in use may be adjusted to a predetermined distancefrom the rear end of the tube 5 whereby the forward movement of the rodduring an operation is limited by the said nut. Near the forward end ofthe rod and made fastthereto are four knives 16 which are radiallyarranged and equidistantly spaced on the rod. The function of theseknives is to divide the stricture by forming four incisions therein andtherethrough. Between the knives and the forward extremity of the rod islocated a feather or spline 17 which follows a slot 18 of the guidemember 19, whereby the knives are held in the center of the slots andaway from the metal edges of the member, thus preventing the possibilityof dulling-them when the instrument is in use. This guide member 19 isslightly curved at its forward extremity as shown at 20 to harmonizewit-h the direction of the inner portion of the urethra which thisportion of the instru ment must enter during every operation forstricture. The forward end of the guide member is provided. with ahollow bulb 21, whose walls are interiorly grooved as shown at 22 toallowthe knives to enter, for the purpose of concealing them during theinsertion of the instrument into the urethra preparatory to cutting thestricture. This bulb is also interiorly threaded as shown at 28, toreceive the threaded extremity 7 of the body member 5 when the parts areas sembled, the forward extremity of the bulb being then in engagementwith the shoulder 8 of the member 5. The hollow portion 24 of the bulbforward of the free end of the part 7, is free to receive and concealthe knives 16. The forward portion of the bulb is provided interiorlywith four tongues 30 between two of which the feather 17 on the rod mustpass when the rod is properly in serted in the guide member, so that theknives will enter the grooves of the bulb. These tongues are alsoproperly arranged to cause the feather 17 of the rod to enter one of thefour slots 18 of the guide member. whereby the knives are properlyguided in the said slots during their movement therein when an operationis performed. I

Attention is called to the factthat the slots 18 of the guide member arein exact alinement with the interior grooves 22 of the bulb so that asthe knives are pushed forwardly out of the grooves in which they arenormally concealed when not in use, they will enter the slots 18 fromwhich they protrude a sufficient distance for stricturecutting purposes.

As illustrated in the drawing the forward portion of the guide tube isprovided with an interior recess 25 located forward of the forwardextremities of the slots 18, the said recess being adapted to receivethe forward extremity 26 of the rod 12 when the latter has reached itsforward limit of movement in the guide member.

The forward portion of the body member 5 is reinforced as shown at 27,and the perforation 28 therethrough is reduced to fit the rod 12,whereby the latter is accurately and centrally guided by the body of theinstrument during an operation. It will thus be observed that the bodymember of the instrument has the opening therethrough at bothextremities reduced to lit the rod quite closely, the plug 9 at the rearend of the instrument serving to accomplish this object as heretoforeexplained. Between the reinforced part 27 and the plug 9, the opening inthe body member is formed relatively large as indicated at 29.

In assembling the parts the ring 13 and the stop nut 15 must be removedfrom the rod, after which the forward end of the latter is inserted inthe front end of the body member 5 and passed therethrough. The nut isthen applied to the threaded portion of the rod and the ring alsoattached. The guide member 19 may then be connected with the forwardthreaded end 7 of the body member, by screwing the same thereon, theforward portion of the rod being inserted in the guide memberpreparatory to making this connection. hen the guide member is screwedhome upon the body member, or so that the forward edge of its bulbengages the shoulder 8, the parts of the instrument are assembled and itis ready for use.

hen in use the forward extremity 20 of the guide member is inserted inthe urethra, the knives 16 being concealed within the bulb 21, the stopnut being moved forwardly upon the rod until it engages the milled head10 of the threaded plug at the rear end of the body member 5, thusmaking it impossible to prematurely move the knives out of their placeof concealment. As the forward extremity 20 of the guide member is quitesmall, the instrument is easily in.- serted. It is then moved forwardlythrough the urethra until the bulb 21 engagesthe" strictured portionthereof. This is easily the bulb is too large to pass therethrough untilthe walls of the stricture are severed The stricture being then found orlocated, the stop nut 15 is run back upon the threaded portion of therod a distance beyond the rear end of the body member 5 equal to thedistance which 'theroperator desires that the knives should travel dur--ing the stricture-cutting operation. The body member of the instrumentis then held and the rod carrying the knives pushedfor wardly until thestop nut 15 engages vthe rear end of the body member. During thismovement the knives 16 will pass through the stricture forming fourincisions the walls thereof. The rod may then be moved rearwardly toconceal the knives within the bulb, after which the body member may bemoved forwardly in the urethra until the bulb passes through the dividedstricture,

thus insuring that the operation has been successful, since if therelatively large bulb will pass through the strictured part, theoperator has positive proof that the work of the instrument has beenproperly accomplished. i

Having thus described my invention, what I claim is: a

1. A urethrotome comprising a main tube or body member, a guide memberconnected with the forward extremity of the body member and having ahollow bulb interiorly grooved, slots extending forwardly from thegrooves, a guide portion located forward of the slots, and a rod passingthrough the body member and entering the guide member which is hollowfor the purpose, the rod being longitudinally movable and having knivesadapted to enter the grooves of the bulb, whereby they are concealed,and also adapted to protrude through the slots'of the guide member. I

2. A urethrotome having a hollow body member, a forwardly located hollowslotted guide member having abulb .at the rear extremities of the slots,a guide portion extending forward of the slots, the bulb also havinginterior grooves in alinement with the slots, and a rod passing throughthe body member, entering the guide member, longitudinally movable,having knives adapted to be concealed in the grooved portion of the bulband to protrude through the slots of the guide member, 'whichis reducedsize forward of the bulb. I V

3. A urethrotome having a relatively large hollow body portion, aninteriorly grooved hollow bulb "at the forward end of the body 'portion,a reduced hollow slottcd portion;

forward of the bulb, a guide portion. forward of the slotted portion,and a rod longitudinally movable in the hollow portions of theinstrument and equipped with knives adapted to be concealed within thegrooved portion of the bulb and to protrude through the slots forward ofthe bulb, for thepurpose set forth. k I

4. A urethrotome having a relatively large hollow body portion, aninteriorly grooved hollow bulb at the forward end of the body portion, areduced hollow slotted portion for ward of the bulb,,a guide portionforward of movable within the hollow portions of the instrument andequipped with knives adapted to be concealed within the grooved portionof the bulb and to protrude through the slots forward of the bulb, therod also having a guide feather. adapted to enter. a slot of the slottedportion, for the purpose set forth. v

5. A urethrotome having a relatively large hollow bodymember, aninteriorly grooved bulb at the forward end of the body member, a reducedhollow slotted portion forward of the bulb, the slots being in alinementwith the grooves of the bulb, a guide portion located forward of theslotted por: tion, and arod adapted to pass through the body member andenter the guide member,

the rod having knives adapted to be con cealed within the groovedportion of the bulb and to protrude through the slots forward of" thebulb, the rod alsohaving a 1 feather located forward of the knives, thebulb being also provided with interiorly lo-' cated tongues spaced tocorrespond with the grooves and slots, the spaces between the tonguesbeing adapted to receive the feather on the rod and maintain the knivesin alinement with the grooves and slots, substantially ass-described. i

6. A urethrotome having a relatively large body member, a hollowinteriorly grooved bulb at the forward end of the body member, a reducedhollow slotted portion forward of the bulb, a guide portion forward ofthe slotted portion, the slots being in alinement with the grooves ofthe bulb, a

rod longitudinally movable in the hollow portions of the instrument andequipped,

with knives adapted tobe concealed within slotted portion forwardo'f'the bulb, a guide portion forward of the slotted portion, and a rodlongitudinally movable in the body member and in the hollow portion ofthe guide member, the rod having four knives adapted to be concealedwithin the grooved portion of the bulb and to protrude from the slotsformed in the guide member forward of the bulb, the rod having a stopnut located in the rear of the body member and having a ring at its rearextremity, substantially as described.

8. A urethrotome having a hollow body portion, an interiorly groovedbulb at the forward end of the body portion, a hollow slotted portionforward of the bulb, the hollow slotted portion being reduced to asmaller size than the bulb and a rod longitudinally movable in thehollow portions of the instrument and equipped with knives adapted to beconcealed within the grooved portion of the bulb and to protrude throughthe slots forward of the bulb.

9. An instrument of the class described having a hollow body portion, ahollow bulb at the forward end of the body portion, a reduced hollowslotted portion forward of the bulb, the hollow of the bulb being largerthan the reduced hollow slotted portion and a rod longitudinally movablein the hollow portions of the instrument and equipped with knivesadapted to be concealed within the bulb and to protrude through theslots forward of the bulb.

10. A urethrotome having a relatively large hollow portion, a rodlongitudinally ment, through which the knife is adapted to protrudeafter leaving the knife-concealing portion in the rear thereof, and aguide portion forward of the hollow slotted portion substantially asdescribed.

11. A urethrotome having a relatively large hollow body portion, a rodlongitudinally movable therein and equipped with knives adapted to beconcealed within the said hollow portion, a reduced hollow slottedportion forward of the lmife-concealing portion of the instrument, and aguide portion forward of the hollow portion the rod being adapted toenter the slotted portion from which the knives protrude through theslots, for the purpose set forth.

In testimony whereof I aiiix my signature in presence of two witnesses.

VILSON BREDIN. Witnesses A. J. OBRIEN,

Copies of this patent may be obtained for five cents each, by addressingthe Commissioner of Iatents, Washington, I). C.

